This invention relates generally to surgical retractors for exposing an operative field during a surgical procedure and, more particularly, to a hand held surgical retractor for the purpose described which minimizes fatigue and discomfort of a surgeon-user who must apply maximum force to the retractor for even very short periods of time.
Uncompromised exposure of an operative field is required for successful surgical procedures. This exposure is achieved by retracting tissues, organs, muscles or bones, as the case may be, away from the operative field. Most surgical procedures are performed by a team including an operative surgeon and at least one assistant surgeon, as required by the complexity of the procedure. The operative surgeon selects and positions the retractor but it is the responsibility of the assistant surgeon to control the retractor once it is set in place.
Prior art hand held surgical retractors have a blade which is maintained in contact with a surgical wound and a handle which is manipulated by the assistant surgeon as may be necessary to maintain exposure of the operative field during the course of the surgical procedure.
The handle is grasped by the assistant surgeon while his/her wrist and hand manipulate the retractor. The forearm muscles provide the required retracting force. It will be readily appreciated that fatigue of the hand, wrist and forearm is a common problem, particularly when the retractor must be controlled for long periods of time as in a complicated surgical procedure. In this regard, it will be appreciated that many surgical procedures extend over a period of several hours. The assistant surgeon may often have a retractor in each hand and may be required to control the retractors with an uninterrupted constant force for these several hours.
The control of prior art hand held retractors originates at the palm of the hand. The wrist joint is used for positioning, stabilizing and applying the retracting force. This rapidly results in hand and forearm fatigue. The force applied to the retractor is exerted by the small muscles of the forearm. The stronger muscles of the arm, shoulder and chest are not active when using a palm based, hand held retractor.
Prior art hand held surgical retractors also require the hand to be maintained at a maximum oblique orientation so that the retractor is positioned parallel to the forearm. The oblique orientation occurs from deviation of the hand at the wrist. This prolonged, unnatural position of the hand further contributes to fatigue and discomfort due to holding a prior art retractor for extended periods of time, or when maximal muscle forces are required.
The present invention obviates the aforementioned disadvantages of prior art hand held surgical retractors by separating and distributing the elements of retractor control to individual regions of the upper extremity of the surgeon controlling the retractor. This prevents the aforementioned fatigue irrespective of when, where or for how long the retractor is used. It should be noted that with prior art retractors, when maximal isometric force is required for retraction of a surgical wound, intolerable fatigue can develop in as short a period of five minutes. With the retractor of the present invention, this fatigue is almost completely eliminated and the surgeon-user can apply the required force for an almost indefinite period. Further, the ergonomic design of the retractor of the present invention eliminates the aforementioned oblique orientation of the hand at the wrist so as to be advantageous over prior art retractors of the type described.